What is HPV?
HPV is human papillomavirus. More than 100 types of this virus can infect humans.

Some types of HPV cause the warts commonly found on hands and feet. Other types of HPV (genital HPVs) cause warts on your genitals or cause changes on a woman's cervix which may lead to cervical cancer.

The types of HPV that cause warts on your hands and feet do not infect your genitals. The types of HPV that infect your genitals do not infect your hands and feet.

Am I at risk for HPV?
If you have ever had sex or experienced intimate touching, you are at risk for HPV.

HPV is very common. Three out of four people will have at least one HPV infection in their lifetime. You can get HPV easily from oral, genital or rectal sex or intimate touching. Most infections will disappear on their own. When they do not disappear these changes can be found with a Pap test and treated with follow-up procedures.

All women who have ever been sexually active (sexual intercourse and intimate touching), regardless of sexual orientation, should have regular Pap tests.

If I have sex with someone of the same sex, should I be concerned about HPV?
Yes, HPV can be passed between any sexual partners.

If I get genital warts or cell changes on my cervix, does this mean my last partner had HPV? Not necessarily. It simply means that at some point in your life you came in contact with the virus.

Can I tell who I got HPV from?
It is usually impossible to tell when or from whom you got the infection.

Is there a test for HPV?
There are new tests for HPV available in some provinces, but they are not routinely available in Manitoba yet. HPV testing may tell if you have a type of HPV at the time of testing. It does not tell if you have been infected in the past. Women can have a Pap test to find changes on the cervix caused by HPV.

Can men get HPV?
Yes, men can get HPV. There are usually no symptoms unless a male has a type of HPV that causes genital warts that are visible bumps on the skin that may feel itchy or irritated.

Can condoms protect against HPV?
Condoms can protect you from many sexually transmitted infections. Condoms may not always protect you against HPV.

How can I reduce the risk?
Not having sex is the surest protection. Ask your doctor or nurse if you should receive the HPV vaccine. Delay sex until your late teens or older. Getting HPV at an early age increases a woman's chances of getting cervical cancer.

If you have sex:

• Always use condoms.
• limit the number of people you have sex with in your lifetime.
• Keep your body healthy and strong so it can fight off infections. Eat healthy, exercise and get enough rest.
• Avoid cigarette smoke as it affects the cells on a woman's cervix.

If I have HPV, does it mean I will get cancer?
No. In most cases HPV does not lead to cancer. Some types of HPV can cause changes on the cervix, which if left untreated, can lead to cervical cancer. Regular Pap tests can find changes in the cervix caused by HPV.

Is there a cure for HPV?
No. There is no cure for the virus. The warts and some cervical changes caused by the virus may disappear on their own. Or they can be treated.

Is there a vaccine for Human Papillomavirus (HPV)?
Two HPV vaccines, Gardasil and Cervarix, have been approved for use in Canada. Gardasil provides protection against four types of HPV: 16, 18, 6 and 11. Cervarix provides protection against two types of HPV: 16 and 18. HPV 16 and 18 cause over 70% of all cervical cancers. HPV 6 and 11 cause 90% of all genital warts. Gardasil is given in three doses over six months. Neither Gardasil nor Cervarix can be used to treat existing HPV infection.

Who should get the vaccine?
Gardasil has been approved for use in females and males between the ages of 9 and 26. The National Advisory Committee on Immunization recommends the use of Gardasil for:

1. Females between 9 and 13 years of age before they start having sexual contact, and
2. Females between 14 and 26, who may:
   • have already been sexually active,
   • have been exposed to HPV infection, or
   • have already had previous Pap test abnormalities.

Who should not get the vaccine?
The use of Gardasil is not recommended for:

• Females under the age of 9, or
• pregnant women.

What is the HPV Immunization Program?
In the 2008-2009 school year, Manitoba Health introduced a vaccine program for grade six girls. It is voluntary. The vaccine is given by public health nurses. Before any female student is immunized, parents and legal guardians receive:

• Information about HPV and the vaccine, and
• a consent form.

How effective is Gardasil?
Gardasil is most effective when given to females before they start having sexual contact. If received before exposure to HPV 16, 18, 6 and 11, it will be almost 100% effective in preventing infection from these four types. If you have previously been infected with one of these four types, the vaccine will still protect you against the remaining three types. The vaccine will not protect you against infection from other HPV types.

How safe is Gardasil?
Gardasil is safe. In recent studies, very few side effects were reported. The most common side effects were soreness, pain and swelling where the vaccine was injected. In one study of 11,640 recipients, there were 5 reports of serious side effects that may have been due to the vaccine. These side effects were:

• Bronchospasm (difficulty breathing),
• gastroenteritis (swelling of the stomach and intestines causing discomfort, loss of appetite, nausea, vomiting and sometimes diarrhea),
• headache and hypertension (high blood pressure),
• vaginal hemorrhage (bleeding),
• injection site pain and difficulty in moving.

During this study, 10 people died. None of these deaths were considered to be vaccine-related. These deaths were caused by trauma, suicide, pulmonary embolus, infection, cancer, a complication of cesarean section, and an arrhythmia.

What is in Gardasil?
Gardasil contains proteins that act like the HPV virus. The body starts making antibodies and white blood cells to fight against these virus-like particles. This builds up immunity to the HPV virus as well. There is no active virus in the vaccine. Nor are there any antibiotics or preservatives, such as mercury or thimerosal.

Is there a cost for the vaccine?
Gardasil is free for grade six girls through the HPV Immunization Program. The vaccine is not free for females outside the program. You can buy the vaccine through your health centre. You may need a prescription. Talk to your doctor about how to get the vaccine.

If I am vaccinated, will I still have to go for Pap tests?
Yes, you will still need to have regular Pap tests because:

• The vaccine does not protect you against all types of HPV that can cause cervical cancer,
• you may have already had an HPV infection when you were immunized, or
• you many not have full protection from the vaccine

Women who have ever been sexually active should have regular Pap tests. Most women need a Pap test once every two years. Ask your health care provider when you are due for your next Pap test.

Regular Pap tests are the best way to reduce your risk of developing cervical cancer.